Conifer Lodge

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Accidents and incidents were documented in detail. This included a reflective section to encourage staff to highlight their own learning points. Systems were in place to review and analyse these to identify any patterns or trends, so action could be taken to minimise any further risks to people. The registered manager also monitored the level of detail provided in the forms to ensure that these were being completed with enough information to be effective. Staff told us that they regularly had opportunities to learn when anything went wrong.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Staff understood the importance of providing key information to other health professionals when people wished to use other or move between services. A relative told us, “[Person] had to go to hospital. They [staff at Conifer Lodge] were marvellous. They took them to the hospital and spent time with them. They arranged it all, I never had to worry.” External professionals spoke positively about their relationship with the home.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us that they felt safe at Conifer Lodge. One told us, “They look after us here, we’re safe.” A relative added, “I never have to worry about their safety. They are happy which means I am happy.” Staff had received appropriate training to enable them to proactively spot any risks or signs of abuse. For example, one person had mentioned in conversation with staff that they had given some money away in the community. Staff supported the person to take action to keep themselves safe from financial abuse. All staff we spoke with demonstrated a good knowledge of safeguarding and information about this was displayed within the home. Staff told us, “We do everything we can to keep people safe. I wouldn’t hesitate to report something if I was worried, and I feel it would be acted on straight away.” The registered manager had reported any issues to the appropriate agencies, including the local authority and Care Quality Commission.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People and their relatives’ views had been sought when it came to assessing and managing risks. There was a good balance of people being protected from harm but being supported to be as independent as possible, even if this involved some positive risk taking. Risks were documented in people’s care plans, along with guidance for staff on how to minimise these. These included risks in relation to choking, falling, skin integrity or people who could neglect themselves. One person was under a specific care plan regarding their mental health. Staff demonstrated robust knowledge of what action needed to be taken if the person started to decline their medicine, as this could have a significant impact on the person’s well-being. These instructions were clearly documented in the person’s care plan. Another person was at risk of developing urinary tract infections (UTIs) due to poor hydration. They had specific fluid charts in place which were regularly audited to ensure their fluid intake was sufficient.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The home was clean and tidy. There was a designated maintenance person to ensure all environmental matters were resolved as quickly as possible. People’s rooms were personalised to their tastes and contained their own property. One relative told us, “[Person] absolutely loves their room, they have all their belongings in there and it is a comfort for them.”

The registered manager kept a robust maintenance schedule to ensure regular environmental checks were completed, for example, fire safety checks and water testing. Equipment was maintained to the expected standard.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

We observed sufficient staff on shift to safely meet people’s needs. This included enough staff to support people to go out when they wished. People and relatives told us that there was always plenty of staff around and spoke positively about the continuity of this. One relative told us, “You always see the same faces. It’s nice as they really get to know people, including me as a visitor.”

Staff were suitably trained and there was an appropriate mix of staff skills on each shift. The registered manager arranged staff to have a specific role each shift. For example, some staff were care workers and provided personal care and so on, then others were recovery workers, who focused on supporting people to work towards their specific life goals.

The provider had a robust recruitment policy in place. Suitable checks of staff had been completed before they started working at the home. This included references from previous employers and Disclosure and Barring Service (DBS) checks.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People and staff worked together to keep the service clean and tidy. There was a designated housekeeping team who followed a robust cleaning schedule to ensure the home remained free from clutter and dirt. Staff were observed to be wearing personal protective equipment (PPE) as appropriate, and regular checks by management were undertaken to ensure this was used safely. Staff had received training and were up to date with current guidance including what to do at times of infection outbreak. The provider had a clear and relevant infection prevention and control policy.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People were given medicines in line with their wishes. We observed one person, who had been put on a temporary medicine, strongly disliked the taste as this was in drink form. The staff member respected their views and contacted the GP proactively to try and source an alternative.

Medicine administration records (MARs) were completed accurately. The management team kept good oversight of these, completing regular audits and taken immediate action if any errors were identified. People who had as and when (PRN) medicines in place, had clear instructions in their medicine records to guide staff on when to offer these, and what to look out for before and after giving them.

Staff had received appropriate training to ensure they gave medicines safely, and had their competency checked frequently.